The Cloud Will See You Now

by Nigel Dessau

A BuzzFeed article from 2013 outlined “20 Reasons Why Going To The Doctor Is The Absolute Worst.” My biggest frustration was number 19: realizing that one 15-minute appointment has taken up the better part of a day. Three years later in 2016 an article on CNBC pointed out how many people were frustrated before arriving at their appointment. A reported 63% of patients said the most stressful thing about going to the doctor was waiting to be seen. In this same survey of over 2,000 patients, 80% went online to book and pay for a trip but 88% of doctors’ appointments are still scheduled by phone.

If you do not think 5 years is very long ago think about how you use services like Uber, Lyftand Airbnb today compared to then. Now, what has changed in healthcare in the last 5 years? For me personally it’s gotten considerably more expensive and harder to access. But it does not need to be. Here are three ways to reduce the frustration and remove the suffering of using the healthcare system

Step 1: Don’t go to the doctor at all

Clearly the easiest way not to suffer the healthcare system is not to engage in it. If you are healthy, this seems an easy way out. But what if you are a sufferer of a chronic illness like Type 2 Diabetes, Chronic Obstructive Pulmonary Disease (COPD) or Congestive Heart Failure (CHF)? Then you need the support of your Primary Care Physician and maybe even two or more specialists.

So, the issue really isn’t about not going, it’s about not going as much. Engagement platforms like Wellsmith can help you here in two significant ways. First, by helping a consumer stick to their prescribed digital Care Plan better, it can reduce or remove the need for unscheduled or emergency health clinic visits. Second, for some, closely following a doctor-prescribed Care Plan may provide an opportunity to eliminate some of the impacts of illness, including reducing or even potentially eliminating medications. If nothing else, following your Care Plan can simplify and improve your quality of life – a direct reflection on how happy you will be.

Step 2: Solve the data dilemma digitally

Accepting that you have to see the doctor occasionally, the next question is, can they come to you?

The most obvious way for the doctor to come to you is a telehealth approach like MDLive. One of Wellsmith’s customers, Cone Health, works with MDLive and believes technologies like this are an important additional access point for patients. In a case study for MDLive, Cone Health Chief Medical Officer for Connected Care Doctor Jenkins, says it this way,

“MDLIVE helps us deliver convenient, patient-centered care for the new generation of health consumers, making them loyal Cone Health customers who will continually choose us for their care.”

A large number of the things that happen at your medical appointment are done to fulfill requirements of your insurer or your health plan. Take the example of visiting your doctor for a sore throat. A simple test available from a pharmacy could answer most of the medical questions your doctor may have, but they still want you to come in. Why? First, they don’t necessarily trust the way the test was taken, but more importantly, that’s how they get paid. Why do they weigh you, take your blood pressure and ask you a bunch of questions? They do so because they are paid to do so. Yes, the information is helpful, but do I really need to take a whole day out of my life to get them the answers, so they can be paid?

You go to the doctor so they can get those readings. Given that most of the metrics your insurer and even your doctor needs can be taken easily from home, let us remove the need to visit by giving them the data they need. At home we can have scales,blood pressure cuffs, Pulse Oximeters and many other consumer-grade devices to measure ourselves and digitally record the data. It’s digital health data collected on your time, not theirs. Of course, while these tools can provide the data, will the doctor trust the data they are getting? At least when you are in their office they have some sort of quality control on data collection.

We believe the answer is working with someone like Wellsmith, who has tested and integrated the digital health devices into our platform. We then provide the doctor or health care provider with confirmed data from the devices, that is not altered or filtered through any other system or process. That data is as good as if you had been in their office – without the hassle of actually going into their office. Clearly the issue of them being paid may still be a blocker. As we move from ‘fee for service’ to ‘outcome based healthcare,’ this problem may fix itself.

Step 3: Stay connected all the time

The only long-term solution here is not about how you get around a visit to your doctor, but how to live a life that avoids the need for doctors where ever possible. While we know that some of this is achievable by eating well and exercising, life is more complex than that. Our bodies are sophisticated machines that contain as much as 60ZB of data. This data can be used for more than just fixing problems; it can be used for preventing problems and thus avoiding the doctor.

By using connected devices and tools in the cloud, AI can start to look for patterns and problems before you know you have them. If you want the see the logical (or some may say creepy) extension to this idea, a video produced by Google in 2016 examines how all these data may look when it is your ‘selfish ledger.’ This utopian(or dystopian) view may be some time away, but the very real benefits of connecting and sharing devices with your healthcare provider are available today.

Patients on a Wellsmith Care Plan use these devices to not only to help them follow their care plans but also let their primary care physicians know where they are on their health journey. As Doctor Stacey Blythe, a Primary Care Physician at Cone Health puts it, “Wellsmith provides patients with valuable information and feedback, allowing providers to better understand what happens to patients when they are not in the office, and thus assist them in their journey to get and stay healthy.”

The Cloud, The future

For some this idea of a connected person will be seen as liberating, and for some it may be seen as deeply concerning. How private and secure will your data be? How will you know the advice or guidance from the cloud is safer or better than you get from your doctor? How do you know the information is not being manipulated to change you or your behavior?

The answer is: we have no real idea today. But then again, many may ask how safe your data is today with your healthcare provider today (try googling “medical records exposed”), how often their doctors get things wrong today (try googling “doctor medical errors”) or how some Cloud providers are accused of trying to manipulate you today (try googling “Facebook influence election”).

The best example here to understand the cultural challenge may be self-driving cars. If a self-driving car has a crash, it is huge news. Take this NYT article to make the point. Even with this sort of coverage, we know two things: self-driving cars are inevitable and they will, in the end, be much safer. The same will be true of self-driving healthcare.